Colistin resistance among multidrug-resistant E. coli isolated from Upper Egypt

El‐Mokhtar, Mohamed A.; Mandour, Sahar; Shahat, Ahmed

doi:10.21608/ejmm.2019.282662

Cited by 8 publications

(11 citation statements)

References 23 publications

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“…Among the 132 strains isolated, a single E. coli isolates harbored the MCR-1 gene and showed resistance to colistin (MIC =8 µg /ml), The remaining isolates were sensitive to colistin with MIC values < 2 µg/ml. These results are similar to studies in Egypt [23,25]. On the other hand, other studies showed that some negative isolates in PCR exhibited phenotypic colistin resistance in MIC [24,26].…”

Section: A Single E Coli Isolates Harbored the Mcr-1 Genesupporting

confidence: 90%

Section: A Single E Coli Isolates Harbored the Mcr-1 Genesupporting

confidence: 86%

“…117 of 132 isolates showed resistance to at least three classes of antibiotics to be multidrug-resistant, and the percentage of E. coli isolates that exhibited MDR (88.64%, 117/132). This finding is supported by other similar UTI studies that showed high resistance rates to the commonly used antibiotics [23]. As a potential justification for the presence of such MDR high rate of MDR in UTI patients because E. coli inducing UTIs are known for their capability to form biofilms that induce recurrent leading to continuous and resistant infection [27].…”

Section: Discussionsupporting

confidence: 67%

“…Despite its low spread, the existence of MCR -1 in a clinical isolate in Jordan could be considered as a sign of start of transmission of resistance genes mainly MCR -1 in E. coli in humans. On the other hand, higher prevalence rates occurred in Egyptian studies with a prevalence rate of 22 % , [23] 5.6 % [24] and 4.5 % [25], and another study on UTIs from Bangladesh with a prevalence rate of 3.52% [26]. Large and improper use of antibiotics creates selective pressure, pursued by the fast rise and outbreak of MDR Enterobacteriaceae [24].…”

Section: Discussionmentioning

confidence: 99%

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Colistin resistance genes inEscherichia coliisolated from patients with urinary tract infections

Al Momani,

Ata,

Maslat

2024

Preprint

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Introduction: Antimicrobial resistance is alarmingly high because it happens in humans, environment, and animal sectors from a "One Health" viewpoint. Due to the fact, that Escherichia coli (E. coli) is broadly disseminated in all sectors, the food web and the environment may have a role in carrying colistin resistance genes from animals to humans. The rise of plasmid-mediated mobile colistin resistance (MCR) genes threatens colistin efficacy, which is the last line to remedy Gram-negative infections multidrug resistance (MDR). Objectives: The current study aimed to investigate development of colistin resistance (MCR 1-5) genes between E. coli isolated from patients with urinary tract infections (UTI) in Jordan. Methods: E. coli (n=132) isolated were collected from urine specimens. E. coli isolated from human UTI patients were examined for genes resistance to colistin MCR (1-5). All isolates were investigated against 20 antimicrobials utilizing the standard disk diffusion method. For analysis of colistin resistance, the broth microdilution technique was employed. In addition, the MCR (1-5) genes were detected by multiplex PCR assay. Results: Out of 132 isolates, one isolate was colistin-resistant, having a minimum inhibitory concentration of 8 μg/mL and possessing the MCR -1 gene. A total of 132 E. coli isolates showed high resistance against penicillin, amoxicillin, cephalexin, nalidixic acid, tetracycline, and cefepime in the percentages of 100%, 79.55%, 75.76%, 62.88%, 58.33%, and 53.79%, respectively. However, resistance was lowest towards fosfomycin (6.06%), florfenicol (10.61%), and chloramphenicol (15.91%). Significant differences were observed between E. coli isolated from pediatrics and those isolated from adults. Conclusion: This is the first report on the presence of the plasmid-coded MCR-1 gene recovered from E. coli from a patient with UTIs in Jordan. That is threatening as colistin is the last line used for infections induced by MDR gram-negative bacteria. There is a crucial need for control and harsh utilization of antibiotics to control and prevent the emergence and prevalence of colistin resistance genes.

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Section: A Single E Coli Isolates Harbored the Mcr-1 Genesupporting

confidence: 90%

Section: A Single E Coli Isolates Harbored the Mcr-1 Genesupporting

confidence: 86%

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

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Colistin resistance genes inEscherichia coliisolated from patients with urinary tract infections

Al Momani,

Ata,

Maslat

2024

Preprint

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“…Colistin resistance signals the breach of polymyxins, one of the last-resort antibiotics for the multidrugresistant Gram-negative bacteria 1. Colistin resistance follows the increasing trend in consumption of colistin in human medicine, especially in countries with high rates of CRE 14, including Egypt 3,15. Prevalence data on colistin resistance are overall scarce 16. The current study reports 2.79 % prevalence rate for colistin resistance.…”

Section: Discussionmentioning

confidence: 99%

Colistin Susceptibility and the Effect of Colistin-sulfadiazine Combination among Multidrug Resistant E. coli and K. pneumoniae at Egyptian Intensive Care Units

El-Sokkary

Gebriel

2019

Egyptian Journal of Medical Microbiology

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Background: Colistin is the last resort for treatment of infections caused by multidrugresistant Gram-negative bacilli. Objectives: This study aimed to evaluate colistin susceptibility among multidrug resistant E. coli and K. pneumoniae isolates, to determine the prevalence of mcr-1& mcr-2 genes carrying isolates and to evaluate the synergistic activity of colistin in combination with the sulfadiazine against colistinresistant isolates. Methodology: 1632 E. coli and K. pneumoniae isolates were collected and identified. Antibiotic susceptibility& MIC for colistin were detected followed by investigating for mcr-1 and mcr-2 genes by PCR. The effect of colistin-sulfadiazine combination was tested by E-test/ agar diffusion method. Results: Among 1218 MDR E. coli and K. pneumoniae isolates, 34 (2.79 %) colistin resistant isolates were detected. The isolates were most frequently isolated from urine 10 (29.4%) and tracheal aspirate 5 (14.7%). Highest resistance rates were reported: ceftazidime (97.1%), cefepime (94.1%), and imipenem (82.3%). Least resistance rates were displayed for amikacin and sulfamethoxazole/trimethoprim (73.5%), and tobramycin (70.5%) respectively. The mcr-1 gene was detected in only one E. coli strain while the mcr-2 gene was not detected. By using colistin-sufadiazine combination, a decrease in colistin MIC ≥ 2 dilutions was observed for 26/34 isolates (76.5%) including the single mcr-1 positive isolate. Conclusion:The spread of colistin resistance threatens its use as the last resort for MDR E. coli and K. pneumoniae. The presence of mcr-1 alarms facing pan-drug resistance among Enterobacteriaceae. To its limit spread, a great concern should be paid to continuous surveillance, putting into practice an effective antibiotic stewardship program and enhanced infection control measures. The use of colistin/sulfadiazine combination represents an alternate and could be used for some cases of colistinresistant Gram negative bacilli.

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Prevalence of Genes Involved in Colistin Resistance inAcinetobacter baumannii:First Report from Iraq

Al-Kadmy

Ibrahim

Al-Saryi

et al. 2020

Microbial Drug Resistance

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Background and aim: Colistin is increasingly being used as a 'last-line' therapy to treat infections caused by multi-drug resistant Acinetobacter baumannii (A. baumannii) isolates, when essentially no other options are available in these days. The aim of this study was to detect genes associated with Colistin resistance in A. baumannii. Methods: 121 isolates of A. baumannii were collected from clinical and environmental samples during 2016 to 2018 in Baghdad. Isolates were diagnosed as A. baumannii by using morphological tests, Vitek-2 system, 16SrRNA PCR amplification and sequencing. Antibiotic susceptibility test was carried out using disc diffusion method. Phenotypic detection of colistin resistance was performed by CHROMagar TM COL-APSE medium and broth microdilution method for the determination of the minimal inhibitory concentration (MIC). Molecular detection of genes responsible for colistin resistance in A. baumannii was performed by PCR. Results: 92 (76%) out of 121 A. baumannii isolates were colistin resistant. 26 (21.5%) out of 121 isolates showed positive growth on CHROM agar Acinetobacter base for MDR. PCR detected mcr-1, mcr-2 and mcr-3 genes in 89 (73.5%), 78 (64.5%) and 82 (67.8%) in the A. baumannii isolates respectively. 78 (64.5%) out of 121 isolates harbored the integron intI2 gene and 81 (66.9%) contained intI3 gene. Moreover, 60 (49.6 %) out of 121 isolates were positive for the quorum sensing Iasl gene Conclusion: The presence of a large percentage of colistin resistant A. baumannii strains in Baghdad may be due to the presence of mobile genetic elements and it is urgent to avoid unnecessary clinical use of colistin.

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Colistin resistance among multidrug-resistant E. coli isolated from Upper Egypt

Cited by 8 publications

References 23 publications

Colistin resistance genes inEscherichia coliisolated from patients with urinary tract infections

Colistin resistance genes inEscherichia coliisolated from patients with urinary tract infections

Colistin Susceptibility and the Effect of Colistin-sulfadiazine Combination among Multidrug Resistant E. coli and K. pneumoniae at Egyptian Intensive Care Units

Prevalence of Genes Involved in Colistin Resistance inAcinetobacter baumannii:First Report from Iraq

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